GoKawiilNeoCOAST-2 trial links ctDNA clearance to better outcomes in lung cancer surgery patients
New secondary results from the NeoCOAST-2 phase 2 trial in resectable stage IIA–IIIB NSCLC show 24-month event-free survival rates of 70.5%, 75.7% and 77.9% across three durvalumab combination arms (with oleclumab, monalizumab, and datopotamab deruxtecan respectively). Clearance of circulating tumour DNA by the third treatment cycle was most frequent in the datopotamab deruxtecan arm (72.5%) and was strongly associated with longer event-free survival, especially when combined with pathological complete response.
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The findings suggest that tracking ctDNA alongside pathological response could give doctors an earlier, more precise way to identify which surgery patients are likely to relapse, potentially guiding follow-up treatment decisions. The researchers note that the datopotamab deruxtecan combination's numerically higher pCR and survival rates warrant further study, implying it could be a promising candidate for future late-stage trials, though this remains an inference pending confirmatory data.
- Datopotamab deruxtecan combination showed the highest ctDNA clearance (72.5%) and event-free survival (77.9%) among the three arms tested
- ctDNA clearance was linked to a strong reduction in relapse risk (HR 0.22), and combining it with pathological complete response further improved risk prediction (HR 0.10)
- Results support further investigation of ctDNA and pCR as combined biomarkers for risk stratification in resectable NSCLC
Source: nature.com — Mcgrath, 2026-10-25
Published there as: “ctDNA clearance and outcomes for resectable lung cancer from NeoCOAST-2”
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